Cultural Competency in Nursing: A Six-Step Change Model
This paper examines the implementation of cultural competency in nursing practice through the Rosswurm and Larrabee six-step model for evidence-based change. Drawing on Watson's theory of human caring, the paper argues that nurses must develop cultural awareness to effectively serve patients from diverse ethnic, racial, and cultural backgrounds. Each step of the change model is outlined in detail — from assessing the need for change and synthesizing research evidence, to designing a pilot training program, evaluating outcomes, and sustaining the change organization-wide. The paper also presents a concrete six-month implementation and evaluation plan, concluding with recommended strategies for maintaining cultural competency as an enduring organizational value.
- Introduction to Cultural Competency in Nursing: Rationale for cultural competency in nursing practice
- Contribution to the Future of Healthcare: How cultural competency shapes future healthcare delivery
- Change Model Overview: Rosswurm & Larrabee's Six Steps: Overview of the six-step evidence-based change model
- Applying the Six Steps to Cultural Competency: Detailed application of each step to nursing training
- Implementation and Evaluation Plan: Six-month timeline and pilot program logistics
- Conclusion: Summary and sustainability of the change initiative
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What makes this paper effective
- The paper applies a well-established evidence-based framework (Rosswurm & Larrabee's six-step model) to a specific clinical problem, grounding practical recommendations in an academic structure.
- Each step of the change model is addressed in a dedicated section, giving the paper a clear, logical progression that mirrors real-world implementation planning.
- The inclusion of a concrete six-month timeline with defined milestones makes the implementation plan actionable and specific rather than abstract.
Key academic technique demonstrated
The paper demonstrates applied framework analysis — taking a theoretical model and systematically mapping it onto a real organizational challenge. By walking through each of the six steps individually and referencing supporting literature (Beach, 2005; Campinha-Bacote, 2002; Tervalon & Murray-Garcia, 1998), the writer shows how scholarly evidence is synthesized to design and justify a practice change rather than simply summarizing research.
Structure breakdown
The paper opens with a theoretical grounding in Watson's human caring theory before establishing the rationale for cultural competency training. It then provides a high-level overview of the Rosswurm & Larrabee model, followed by six dedicated sections — one per step — covering assessment, problem linkage, evidence synthesis, practice design, implementation, and maintenance. The paper closes with a phased evaluation timeline and a bulleted list of sustainability steps, followed by a brief conclusion and reference list.
Introduction to Cultural Competency in Nursing
The foundational knowledge required in nursing and medical practice needs substantial development in order to be effective and appropriate in addressing the needs and preferences of patients. Watson emphasizes the importance of integrating a humanistic dimension into the nursing profession and believes in the necessity of establishing a caring relationship between patients and nurses — one that demonstrates unconditional acceptance of patients in any condition. Nurses should integrate holistic and positive treatment with the aim of promoting health through knowledge and evidence-based interventions, thereby eliminating interruptions during treatments, or what Watson calls "caring moments."
Modern patients present diverse problems and concerns stemming from cultural differences, racial backgrounds, and ethnicity, which underscores the need to strengthen the capacities of nurses. Ensuring that nurses obtain cultural competencies is essential for enhancing their ability to address the wide range of issues and needs faced by patients across different backgrounds.
Contribution to the Future of Healthcare
This model of change has a significant influence on the future of healthcare because of its potential to increase the output of medical practitioners and institutions. The model will ensure that every nurse in the workplace possesses valuable cultural competency as a prerequisite for working within medical facilities. It is clear and precise in aligning with the policies that call for cultural competency among nurses.
Cultural competency will enhance nurses' ability to address the needs and preferences of patients in an era of globalization characterized by diversity in ethnicity, race, and culture. It will also improve the quality of services delivered to patients and foster the development of meaningful, respectful relationships between patients and healthcare providers.
Change Model Overview: Rosswurm & Larrabee's Six Steps
The Rosswurm and Larrabee Model of Evidence-Based Practice Change provides six critical stages toward achieving meaningful change in the healthcare sector through nursing. The first step focuses on assessing the need for change in nursing practice. The second step involves linking the identified problem, relevant interventions, and expected outcomes to nursing practice. The third step synthesizes the best available evidence through literature review and key research findings. The fourth step focuses on designing the desired practice change and identifying the key players and stakeholders involved. The fifth step involves implementing and evaluating the change. Finally, the sixth step addresses the integration and maintenance of the change in practice.
Conclusion
There is a clear need to integrate a structured approach toward ensuring up-to-date cultural competency that meets established standards and addresses the needs and preferences of patients. Culturally competent nurses are essential for responding to the demands of an increasingly diverse patient population. The structured approach presented in this paper is realized through the Rosswurm and Larrabee six-step model for evidence-based practice change, which equips nursing staff with the cultural knowledge and skills needed over a six-month period, followed by a rigorous evaluation process to ensure the sustainability of the change.
References
Anderson, N. L. R., Calvillo, E. R., & Fongwa, M. N. (2007). Community-based approaches to strengthen cultural competency in nursing education and practice. Journal of Transcultural Nursing, 18(1), 49S–59S.
Beach, M. C. (2005). Cultural competency: A systematic review of health care provider educational interventions. Cultural Competency, 43(4), 356–373.
Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181–185.
Rosswurm, M. A., & Larrabee, J. H. (1999). A model for change to evidence-based practice. Image: Journal of Nursing Scholarship, 31(4), 317–322.
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 118–125.
Vanguard Health System. (2011). Jean Watson's theory on human caring. Retrieved August 1, 2013, from www.innovativecaremodel.com
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